EMS Providers Need More Training for WMD, CBRNE Incidents

EMS Providers Need More Training for WMD, CBRNE Incidents

Article Nov 16, 2012

Weapons of mass destruction (WMD) training programs remain as vital to today’s first responders as they have been for the past 10-plus years. Effective WMD training ensures our nation’s responders can effectively mitigate acts of terrorism, minimize casualties, protect our citizens and restore our communities following an incident.

Unfortunately, many EMS providers around the country report feeling inadequately trained to respond to acts of terrorism involving chemical, biological, radiological, nuclear or explosive (CBRNE) materials. And of the EMS providers who do receive WMD training, many report it is only minimal. A December 2004 round table discussion from New York University’s Center for Catastrophe Preparedness and Response, reported more than half of EMS providers receive less than one hour of training in biological, chemical and explosive hazards, with 20% receiving no WMD training at all.1 This national roundtable also noted that fire department-based EMS providers received more training in homeland security and disaster management than non-fire-based EMS. Additionally, EMS providers in urban areas reported receiving more training, compared to their rural counterparts.1

A more recent survey conducted by Meridian Medical Technologies indicates there has been little change in WMD training for EMS providers to effectively respond to CBRNE incidents. Of those surveyed, only 37% reported an increase in WMD training over the last five years, while 25% reported a decrease, or no training at all. The survey also found only 42% of respondents reported receiving recurring training.2 Despite the Meridian Medical Technologies survey indicating a deficiency in WMD training, greater than 70% of the respondents expressed concern that a WMD incident will occur in the near future with widespread consequences.

A study published in 2005 analyzed all bombing incidents in the United States from January 1983 to December 2002 found 36,110 bombing incidents, resulting in 5,931 injuries and 699 deaths.3 Bombing incidents in the U.S. are a serious threat and they are a common practice in acts of terrorism. Following the Sept. 11 terror attacks the United States continues to be a terrorist target, making WMD training essential for EMS providers. Failed terrorist attempts against the U.S. include Richard Reid’s attempted shoe bombing aboard American Airlines flight 63; Umar Farouk Abdulmutallab’s failed attempt to detonate a bomb concealed in his underwear aboard Northwest flight 253; and Faisal Shahzad’s attempted Times Square bombing. Thwarted attempts include Jose Padilla’s plan to detonate a radioactive dispersal device (RDD); a 2009 Bronx terrorism plot; a Columbus shopping mall bombing plot; and the 2007 Fort Dix attack plot. Successful attacks consist of the 2001 anthrax letters, resulting in five deaths; 2009 Little Rock recruiting office shooting; Fort Hood shooting; and the 2002 shooting at LAX’s El Al ticket counter, killing three. These attacks are only a handful of the terrorist-related incidents that have occurred in the U.S. since 2001. Furthermore, a 2011 Newsweek article published results from an Alabama-based civil rights group indicating the number of U.S.-based right wing extremist groups increased from 149 to 824, mainly due to various recent economic and political changes, such as the Patriot Act.4 These incidents indicate the increasing variety of terrorist threats in the U.S., from both domestic and foreign groups.

Today’s continual terrorist threat makes WMD training imperative for EMS providers. EMS providers should receive regular high quality training to ensure confidence in responding to these and other CBRNE incidents. The Department of Homeland Security training consortium provides high quality WMD training at no cost to our nation’s first responders. The covered costs include travel accommodations, lodging and a meal per diem. The DHS training consortium consists of the Center for Domestic Preparedness in Anniston, AL, the Energetic Materials and Research Testing Center (EMRTC) at New Mexico Tech (NMT), Louisiana State University (LSU) National Center for Biomedical Research and Training (NCBRT), Texas Engineering Extension Service (TEEX), U.S. Department of Energy’s Nevada Test Site, and the Security and Emergency Response Training Center (SERTC) in Colorado.5 Each location within the consortium teaches a different aspect of WMD emergency response. Many of these training programs offer a mobile training team capable of traveling throughout the country to provide valuable training to first responders. The mobile training teams also provide training in preparation for high profile or national special security events (NSSE), such as the Republican and Democratic national conventions.6 Additionally, online training programs are also available free of charge to our first responders.

The Energetic Materials and Research Testing Center at New Mexico Tech educates first responders in terrorist use of explosives. The Incident Response to Terrorist Bombings (IRTB) class provided by EMRTC has trained approximately 420,000 first responders at both the awareness and performance levels. The awareness class is a four-hour course that orients first responders to the basics of improvised explosive device (IED) recognition. The performance level takes place in Socorro, NM, and offers an in-depth recognition of improvised, commercial and military explosives with daily field exercises.7 This program does not maintain statistics regarding participant’s primary job function.8 Although it is unclear how many EMS professionals are taking advantage of this course, it is an important resource to EMS training. EMRTC also offers a two day Medical Preparedness and Response for Bombing Incidents (MPRBI) class. This class, provided throughout the country, prepares healthcare professionals to effectively manage a terrorist bombing incident.9

The Center for Domestic Preparedness (CDP) in Anniston, AL, provides first responders with hands on training in CBRNE weapons. Additionally, the CDP trains healthcare professionals at the Noble Training Facility (NTF), which is the only hospital facility in the U.S. dedicated to training healthcare professionals in disaster preparedness and response.10 One class offered by the CDP designed for EMS and healthcare providers is Program Y: Emergency Medical Operations (EMO) for CBRNE Incidents and Hands-On Training (HOT-I) for CBRNE Incidents. The EMO provides three days of lectures, hands-on training and practical exercises, covering treatment of victims, ability to perform triage in personal protective equipment (PPE), decontamination procedures and treatment protocols. The class concludes on day three with a practical exercise covering material learned during the course. The HOT-I is a one-day course teaching first responders from any discipline to respond to a CBRNE incident. The HOT-I class provides students with practical exercises to improve knowledge and skills promoting a safe CBRNE response. HOT-I graduates are able to utilize PPE, radiological and chemical sampling and monitoring equipment, and conduct MCI operations in PPE.11

Despite the availability of high quality WMD training provided by the CDP, EMS participation represents a very small percentage of the student population in resident training programs. EMS participation in non-resident training represents a significantly smaller percentage of the student population. Resident training consists of hands-on training conducted at the CDP facilities in Alabama. Non-resident courses conducted throughout the country include courses taught by mobile training teams. The tables below depict the percentage of students claiming EMS as their primary profession from fiscal years 2005 through 2012. The first table depicts the percentage in resident training while the second depicts the percentage in nonresident training. The CDP training staff averages approximately 90,000 students a year through resident, non-resident and indirect training programs. Approximately 12,000 of these students receive training at the CDP’s Alabama facility.6

Today’s increasing threat of terrorism in the United States requires regular, effective and high quality WMD training. This allows America’s first responders to safely respond and manage CBRNE incidents. Regular, safe and effective WMD training remains essential to any EMS training and continuing education program. The DHS training consortium offers beneficial cost effective WMD training opportunities for first responders from any discipline. Program graduates are educated to recognize indicators of a potential terrorist attack and provide a safer, more effective response in the event of an actual CBRNE incident. A safe and effective response comes from thorough preparation. As EMS professionals—paid or volunteer—we must take advantage of this invaluable training.

To register for Program Y or other CDP training programs, visit the application page at http://cdp.dhs.gov/registration/index.html.

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Students wishing to register for the IRTB course at New Mexico Tech should visit http://www.emrtc.nmt.edu/training/irtb.php.

Information regarding the DHS training consortium members and available training programs can be found at http://training.dps.mo.gov/trainingwebsite.nsf/LinksView/A87440DDFF5D4CB9862574F900080E11?Opendocument.


  1. Robyn K. The Forgotten First Responder. EMS World, www.emsworld.com/10323876.
  2. Smith S. Are First Responders Prepared for CBRNE incidents? EHS Today, ehstoday.com.
  3. Kapur GB, Hutson HR, et al. The United States twenty-year experience with bombing incidents: implications for terrorism preparedness and medical response. J Trauma, 2005 Dec; 59(6):1436–44.
  4. Schneiderman RM. My Life as a White Supremacist. Newsweek, www.thedailybeast.com/newsweek/2011/11/20/my-life-as-white-supremacist.html.
  5. U.S. Department of Homeland Security Training Consortium. training.dps.mo.gov/trainingwebsite.nsf/LinksView/A87440DDFF5D4CB9862574F900080E11?Opendocument.
  6. Arledge S. Personal correspondence, May 8, 2012.
  7. Incident Response to Terrorist Bombings (IRTB) Course. New Mexico Tech, www.emrtc.nmt.edu/training/irtb.php.
  8. Campbell R. Personal correspondence, Apr. 6, 2012.
  9. Medical Preparedness and Response for Bombing Incidents (MPRBI) Course. New Mexico Tech, www.emrtc.nmt.edu/training/mprbi.php.
  10. Center for Domestic Preparedness, cdp.dhs.gov.
  11. Program Y (EMO/HOT-I) Courses. cdp.dhs.gov/schedules/program/y.html.



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